Working in the ICU in India

With three weeks in India, we have had just a little time in many different departments in the hospital. One of the most rewarding, yet most challenging placements has been in the Intensive Care Unit. In this unit we have seen many different critically ill patients with diseases ranging from Acute Renal Failure to Heart Attacks to Poisonings to Brain bleeds and comas. We have been able to work with staff nurses, care for these patients, talk with their families, and interact with other medical professionals to help give our patients the most complete care possible.

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Some of the biggest challenges have been a lack of hospital resources, patients’ lack of money, and challenging diseases and conditions to manage. As a charitable hospital, Choithram works to give low-cost care and minimize the use of resources. This can make it difficult for complex procedures to be performed and supplies can be scarce. In addition, many patients cannot afford to pay for all of the procedures, medications, and medical care that they need to recover. This is especially true for patients in the ICU, as the interventions they need are often more complex, and therefore, more costly. Because most people don’t have insurance, families will sell off their possessions, property, and anything else they can to pay for the hospital bill.

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One of the most difficult cases I came across was with a man who had a heart attack with a complete heart block. He needed three different interventions immediately in order to have the best chance of survival, but his family could only afford for one procedure to be done. A day after the first procedure was done, the family was able to find some more money to pay for the second procedure. The third day, as the patient continued to decline, the family finally came up with more money for the third procedure to be done. The patient lived for a few more days, but because of the extensive damage to the heart and the delay in performing all three procedures, the patient ended up dying. If all three procedures had been done on the first day, there would have been a very high chance he would have survived. But because of a lack of money, it was simply not possible. Situations like these are very difficult to handle. Finally, so many patients have very complex conditions that are not easy to treat. Treatment is not straightforward, and often, despite the doctors and nurses best efforts, the patients end up dying.

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Although there are many challenges working in the ICU, there is also so much value in the time we have spent there and it has been very rewarding. The doctors and nurses in the ICU are some of the most talented healthcare professionals in the hospital because they handle the most complex cases. I have learned so much from them, more than I would have learned in any other department. In addition, because the patients always have very complex cases, it has given me a chance to see more complicated nursing care and has helped me to learn how to manage many different conditions at one time. I have been with nurses who have taught me what to monitor, how to administer different medications, and how to manage care for critically ill patients. Even though it is hard to see patients so sick, it is also rewarding to know that you can make a difference in their life. Sometimes when people are at their worst point is when you can make the biggest difference. I have experienced this here and am so thankful for the opportunity I have had to have a clinical rotation here in the ICU.